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Pregnancy and Drug Use: The Facts

By combining drug war propaganda with claims of fetal rights, new and significant violations of civil liberties and human rights are occurring. In the last twenty years, hundreds of pregnant women and new mothers have been arrested, based on the argument that a pregnant woman’s drug use is a form of abuse or neglect. In 1997, the South Carolina Supreme Court held that a pregnant woman who used cocaine and who gave birth to a healthy baby could be convicted of child abuse. More recently, a pregnant woman who used cocaine and suffered a stillbirth that was caused by an infection-- has been convicted of homicide by child abuse in South Carolina. More than eighteen states now address the issue of pregnant women’s drug use in their civil child neglect laws, and a growing number of these states make it possible to remove a child based on nothing more than a single positive drug test. Like other applications of the war on drugs, the punishment of pregnant women targets vulnerable, low-income women of color—those with the least access to health care or legal defense.

These cases represent a significant expansion of the war on drugs. Pregnant women who are addicts can go to jail, despite Supreme Court rulings that treat addiction as a disease --and punishment for it as a violation of the Constitution's prohibition on cruel and unusual punishment. Similarly, despite the fact that people who are treated for drug related health problems are supposed to have extra protections under the federal drug treatment confidentiality statute, S.C., by reinterpreting drug use as child abuse, creates a devastating exception to the statute’s privacy protections.

NAPW seeks to ensure that addiction and other health and welfare problems women face during pregnancy are addressed as health issues, not as crimes; that families are not needlessly separated, based on medical misinformation; and that pregnant and parenting women have access to a full range of reproductive health services, as well as non-punitive drug treatment services.

NAPW believes that without a comprehensive strategy to undo decades of misinformation and political posturing about pregnancy and drug use, an ever-widening circle of women will be caught in increasingly punitive, intrusive, and coercive government controls that hurt rather than help women and their families. Similarly, drug policy reform efforts to de-stigmatize drug users and to shift policies from punishment to treatment will fail if the myth of crack babies and crack mothers destroying a generation of children is left unchallenged. And, while failure to address the intersection of these issues could lead to further erosion of both drug policy reform efforts and reproductive rights, the ability to take on these issues in a coherent manner provides a unique opportunity to enlist the support of new organizations and communities in the struggle for drug policy reform, and a more just society.

In this section you will find statements from leading scientists, medical researchers, medical, public health, and child welfare organizations addressing the issues of pregnancy and drug use. You will also find articles discussing why some women use drugs during pregnancy and how stigma and misinformation not only hurt pregnant women but also their children, families, and communities.

In December 2015, Reuters released an investigative report, “Helpless & Hooked.” It alleges that the failure of physicians and hospitals to consistently report women who used drugs while pregnant (including those who used drugs prescribed by physicians) and the failure of child welfare systems to intervene in such cases directly or indirectly contributed to the preventable deaths of 110 infants nationwide.

National Advocates for Pregnant Women (NAPW) recognizes that every infant death is a grave loss. We also recognize, however, how much harm has been done to American families in the name of protecting children. This Reuters series is the latest in a long line of journalistic reports that perpetrate stigma.

On February 7, 1992, Martina Greywind, a twenty-eight-year-old homeless Native American woman from Fargo who was approximately twelve weeks pregnant, was arrested. She was charged with reckless endangerment based on the claim that by inhaling the vapors of paint fumes, she was creating a substantial risk of serious bodily injury or death to her unborn child. The complaint alleged:

[The] defendant willfully created a substantial risk of serious bodily injury or death to another, to-wit: . . . MARTINA GREYWIND, while pregnant intentionally inhaled the vapors of a volatile chemical in violation of North Dakota Century Code 12.1-31-06 and thereby willfully created a substantial risk of serious bodily injury or death to her unborn child.

On February 10, 1992, Ms. Greywind, without a lawyer, initially pleaded guilty. She was sentenced to nine months at a state prison farm and ordered to participate in a chemical dependency program. After an attorney took her case, however, Ms. Greywind was allowed to withdraw her plea on February 12, 1992.

During this time, members of the Lambs of Christ were active in Fargo attempting to disrupt the Fargo Women's Health Clinic, the only abortion clinic in North Dakota. The Lambs of Christ is a loosely organized group of Roman Catholics who "focus on the rescue of unborn children." They had been in North Dakota since March and members of their group had been repeatedly jailed. News stories about the case reported that members of the group who had been arrested attempted to befriend Ms. Greywind while they were in jail together.

According to court records and the press, Lambs of Christ spokesperson Ronald Maxson posted $100 for a $1000 personal recognizance bond for Ms. Greywind. Nine hours after her release on bail, Ms. Greywind was re-arrested because police allegedly caught her sniffing paint again. She pleaded guilty to illegal inhalation of chemical vapors and was transferred to the state mental hospital. The State's Attorney said Ms. Greywind was to spend thirty days in the hospital or jail as her sentence. On February 20, 1992, a lawyer for the Lambs of Christ filed a petition seeking to have the woman's brother, Ken Greywind, appointed her legal guardian, apparently in an effort to prevent Ms. Greywind from having an abortion. According to an affidavit filed by Mr. Greywind, "I believe she is contemplating an abortion in order to have the charge of reckless endangerment dismissed and get out of jail so she can continue to abuse her body." The court denied Mr. Greywind’s petition.

On February 21, 1992 the State and Ms. Greywind entered a stipulation -- an agreement between the parties -- that Ms. Greywind “be released from the Cass County Jail for the following medical and/or psychological appointment: February 22, 1992, at 11:00 A.M.” According to press reports, this release enabled Ms. Greywind to obtain an abortion at the Fargo Women’s Health Clinic. Ms. Greywind obtained the abortion, despite widely-publicized efforts by abortion opponents to persuade her to carry the pregnancy to term including a financial offer conveyed by the Lambs of Christ of at least $10,000. Ms. Greywind expressed a desire to have the abortion, but also her inability to pay the cost of the procedure. North Dakota law prohibited state funding of abortion. According to the press, anonymous donors offered to pay for the $300-400 cost of her abortion. On February 24, 1992, Mr. Maxson of the Lambs of Christ requested that the $100 bail be returned to him. The request was granted.

On March 30, 1992, Ms. Greywind filed a motion to dismiss the charges arguing that “the State in this case [was] seeking to criminalize the pregnancy of a drug-addicted woman by applying a strained and unforeseen construction of the North Dakota reckless endangerment statute," as well as other grounds including the fact that the abortion rendered the case moot. Assistant Cass County Prosecutor Steve Dawson then filed a motion to dismiss with prejudice stating:

On February 10, 1992 [Martina Greywind] was charged with the offense of Reckless Endangerment, a class A misdemeanor. The defendant has recently undergone treatment at the North Dakota State Hospital and is presently in custody at the Cass County Jail on a subsequent and pending charge of Inhalation of Volatile Chemicals in violation of N.D.C.C. Section 12.1-31-06. Defendant has made it known to the State that she has terminated her pregnancy. Consequently, the controversial legal issues presented are no longer ripe for litigation. Further, the likelihood of this extreme factual situation recurring is limited. In the interest of preserving limited prosecutorial and judicial resources, Plaintiff hereby moves to dismiss the Complaint in this action with prejudice.

According to news reports, the prosecutor in the case stated that since Ms. Greywind had the abortion, it was “no longer worth the time or expense to prosecute her.” On April 10, 1992, the child endangerment charge was dismissed.

Based on the extraordinary misinformation that appeared frequently in the popular press, many people believe that a pregnant woman who uses any amount of an illegal drug or alcohol will inevitably harm or even kill her fetus. But media hype is not the same as science. As explained by Dr. Deborah Frank in this on-line video, Prenatal Drug Exposure: Award-Winning Pediatrician Discusses What The Science Tells Us,[i] popular news reports have misrepresented the scientific facts about prenatal exposure to drugs.

The New York Times reported this year on the latest research on children exposed prenatally to crack cocaine. Read The Epidemic That Wasn't to learn about their studies showing that crack exposure does not have the devastating effects on development once assumed.

This is a video based on a lecture that Dr. Deborah A. Frank, Pediatrician gave on February 11th 2009 at a continuing education program entitled Drugs, Pregnancy and Parenting: What the Experts in Medicine, Social Work and Law Have to Say.

At the request of activists in Tennessee, NAPW analyzed two 2009 bills in Tennessee concerning pregnant women. Pursuant to Tennessee bills SB1065 and HB0890, pregnant women who meet certain criteria would be tested for alcohol and drugs in order to encourage them to seek immediate treatment for an alcohol-related or drug- related problem. Our analysis of the bills makes clear that this legislation lacked foundation in evidence based research and would undermine, rather than promote maternal, fetal, and child health. It is our understanding that the bill was withdrawn in March of 2009.

DHHS Substance Abuse Mental Health Administration recommends the adoption of the standards used for urine drug testing in the workplace as proscribed by the federal workplace drug testing guidelines if routine alcohol and drug testing is performed on pregnant women. Those guidelines are available here: Mandatory Guidelines for Federal Workplace Drug Testing Programs.

Recently (July 27, 2005), Medical News Today (MNT) carried a story with the alarming title, "Single prenatal dose of meth causes birth defects." Join Together, a prominent website, published a summary of the story with a similar headline and opening with the possibly more inflammatory, "Pregnant women who use methamphetamine even once put their unborn children at risk of birth defects" (July 29, 2005). These headlines misleadingly imply that the research involved women when it actually involved mice, and both the original story and the Join Together summary failed to mention that this animal research may have little if any bearing on the health outcome of humans prenatally exposed to methamphetamines.

On July 25, 2005 more than 90 leading medical doctors, scientists, psychological researchers and treatment specialists released a public letter calling on the media to stop the use of such terms as "ice babies" and "meth babies." This prestigious group agrees that these terms lack scientific validity and should not be used.

Recently (July 27, 2005), Medical News Today (MNT) carried a story with the alarming title, "Single prenatal dose of meth causes birth defects." Join Together, a prominent website, published a summary of the story with a similar headline and opening with the possibly more inflammatory, "Pregnant women who use methamphetamine even once put their unborn children at risk of birth defects" (July 29, 2005). These headlines misleadingly imply that the research involved women when it actually involved mice, and both the original story and the Join Together summary failed to mention that this animal research may have little if any bearing on the health outcome of humans prenatally exposed to methamphetamines...Read More

Motherisk is a "source for evidence-based information about the safety or risk of drugs, chemicals and disease during pregnancy and lactation." (NAPW does not, however, warrant or gaurantee the accuracy of information on this site or any other site to which NAPW links that relates to medical information, nor is this site nor any other site that NAPW links to intended to substitute for professional medical advice, to contradict medical advice given or to substitute for medical care of any kind. )http://motherisk.org/

When four starving boys aged 19, 14, 10 and 9, were taken from their New Jersey adoptive parents last October, all were severely emaciated. The oldest was so stunted--he weighed 45 pounds and measured four feet tall--that police thought he was a grade-schooler. He had been found by neighbors, rooting through their trash for food at 2:30 a.m. He was so weak, he couldn't even open the Tastykake they hastily offered.

Because NAPW believes in evidence based medicine and policies based on science not stigma, we joined a letter addressed to Ambassador Randall Tobias, Office of the United States Global AIDS Coordinator, expressing concern about US officials who questioned the efficacy of needle exchange programs and sought to block support for needle exchange in United Nations resolutions and policy documents. As the letter explained:

In this paper we present analyses of two National Institute on Drug Abuse-funded studies entitled, "An Ethnographic Study of Pregnancy and Drug Use" (Rosenbaum and Murphy 1991-94) and "An Ethnography of Victimization, Pregnancy and Drug Use," (Murphy 1995-98). Our goal is to explicate the ways in which pregnant drug users in the San Francisco Bay Area experienced, coped with and protected themselves from increasing stigmatization, abuse and punishment while enduring a period of fiscal retrenchment of government assistance programs.